02814nas a2200361   4500000000100000008004100001260001200042653002600054653002300080653001900103653001500122653002400137653001200161100001600173700001700189700001500206700001500221700001700236700001300253700001100266700001200277700001300289700001100302700001300313700001600326700001500342700001200357700001400369245013400383856026000517520166100777022001402438       2020                            d  c07/202010aBolsa Familia program10aHansen’s disease10acash transfers10ainequality10aInfectious Diseases10apoverty1 aPescarini J1 aWilliamson E1 aIchihara M1 aFiaccone R1 aForastiere L1 aRamond A1 aNery J1 aPenna M1 aStrina A1 aReis S1 aSmeeth L1 aRodrigues L1 aBrickley E1 aPenna G1 aBarreto M00aConditional Cash Transfer Program and Leprosy Incidence: Analysis of 12.9 Million Families From the 100 Million Brazilian Cohort.  uhttps://watermark.silverchair.com/kwaa127.pdf?token=AQECAHi208BE49Ooan9kkhW_Ercy7Dm3ZL_9Cf3qfKAc485ysgAAApswggKXBgkqhkiG9w0BBwagggKIMIIChAIBADCCAn0GCSqGSIb3DQEHATAeBglghkgBZQMEAS4wEQQMKOKJZjPWk0GYB1obAgEQgIICTpwqlW1LCHipNWSN5kL-YMRVBSQeMn5HCcXHqluaUzuSrLj3 a<p>Leprosy is a neglected tropical disease predominately affecting poor and marginalized populations. To test the hypothesis that poverty-alleviating policies may be associated with reduced leprosy incidence, we evaluated the association between the Brazilian Bolsa Familia conditional cash transfer Program (BFP) and new leprosy case detection using linked records from 12,949,730 families in the 100 Million Brazilian Cohort (2007-2014). After propensity score matching BFP beneficiary to non-beneficiary families, we used Mantel-Haenszel tests and Poisson regressions to estimate incidence rate ratios (IRRs) for new leprosy case detection and secondary endpoints related to operational classification and leprosy-associated disabilities at diagnosis. Overall, cumulative leprosy incidence was 17.4/100,000 pyr (95%CI: 17.1, 17.7), and markedly higher in "priority" (high-burden) versus "non-priority" (low-burden) municipalities (22.8/100,000 pyr, 95%CI: 22.2, 23.3 versus 14.3/100,000, 95%CI: 14.0, 14.7). After matching, BFP participation was not associated with leprosy incidence overall (IRRPoisson 0.97, 95%CI: 0.90, 1.04) but was associated with lower leprosy incidence when restricted to families living in high-burden municipalities (IRRPoisson 0.86, 95%CI: 0.77, 0.96). In high-burden municipalities, the association was particularly pronounced for paucibacillary cases (IRRPoisson 0.82, 95%CI: 0.68, 0.98) and cases with leprosy-associated disabilities (IRRPoisson 0.79, 95%CI: 0.65, 0.97). These findings provide policy-relevant evidence that social policies may contribute to on-going leprosy control efforts in high-burden communities.</p>  a1476-6256